The Genius Life 572: PCOS and Endometriosis – What Every Woman Needs to Know, and Most Doctors Miss | Thais Aliabadi, MD
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May 4, 2026 
Thais Aliabadi, MD, a board-certified OB-GYN specializing in complex women’s health, explains why PCOS and endometriosis are often missed. She covers diagnostic gaps, hormonal and metabolic drivers, the tie between insulin and symptoms, pain mechanisms and central sensitization, treatment options from lifestyle to surgery, and how to push the system toward better care.
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PCOS Requires Two Of Three Specific Criteria
- PCOS is diagnosed when two of three criteria are met: irregular cycles, characteristic ovarian morphology on ultrasound, or symptoms of elevated testosterone.
- Presentations vary widely: some have regular periods but ultrasound or androgen symptoms, explaining frequent missed diagnoses.
PCOS Starts With A Fast GnRH Pulse Altering LH Production
- PCOS stems from a brain–ovary axis dysfunction: accelerated GnRH pulses shift pituitary output toward more LH, which drives ovarian theca cells to make excess testosterone.
- Excess ovarian testosterone stalls follicle growth, creating stuck antral follicles and anovulation.
Insulin Resistance Amplifies Ovarian Androgen Production
- Insulin resistance amplifies PCOS by causing high insulin spikes that lower SHBG and directly stimulate ovarian testosterone production.
- This creates a metabolic loop: visceral fat, inflammation, lower SHBG, and more ovarian androgen output.